Jun 20, 2013 - ... gas exchange [9]. Extracorporeal lung support (ELS) devices such as ... artificial arterio-venous shunt with an interposed extracor- poreal membrane ... coagulation and clotting parameters, hemoglobin and liver enzymes.
Ried et al. Critical Care 2013, 17:R110 http://ccforum.com/content/17/3/R110
RESEARCH
Open Access
Extracorporeal lung support in trauma patients with severe chest injury and acute lung failure: a 10-year institutional experience Michael Ried1*†, Thomas Bein2†, Alois Philipp3, Thomas Müller4, Bernhard Graf2, Christof Schmid3, David Zonies5, Claudius Diez3 and Hans-Stefan Hofmann1
Abstract Introduction: Severe trauma with concomitant chest injury is frequently associated with acute lung failure (ALF). This report summarizes our experience with extracorporeal lung support (ELS) in thoracic trauma patients treated at the University Medical Center Regensburg. Methods: A retrospective, observational analysis of prospectively collected data (Regensburg ECMO Registry database) was performed for all consecutive trauma patients with acute pulmonary failure requiring ELS during a 10-year interval. Results: Between April 2002 and April 2012, 52 patients (49 male, three female) with severe thoracic trauma and ALF refractory to conventional therapy required ELS. The mean age was 32 ± 14 years (range, 16 to 72 years). Major traffic accident (73%) was the most common trauma, followed by blast injury (17%), deep fall (8%) and blunt trauma (2%). The mean Injury Severity Score was 58.9 ± 10.5, the mean lung injury score was 3.3 ± 0.6 and the Sequential Organ Failure Assessment score was 10.5 ± 3. Twenty-six patients required pumpless extracorporeal lung assist (PECLA) and 26 patients required veno-venous extracorporeal membrane oxygenation (vv-ECMO) for primary post-traumatic respiratory failure. The mean time to ELS support was 5.2 ± 7.7 days (range,
